Micropapillary carcinoma of lung

Micropapillary architecture occurs in adenocarcinoma of the lung, breast, colon and ovary, and in transitional cell carcinoma of the urinary bladder. In lung, breast and bladder, a micropapillary component is associated with more aggressive behavior and metastases tend to have a micropapillary architecture. Micropapillary serous carcinoma of the ovary has a significantly worse prognosis than do typical serous borderline tumours2.

One study found a micropapillary component in 16 of 35 stage I lung adenocarcinomas, suggesting a more lax criterion and usual: even so there was an association with nodal micro-metastases4.

Histopathology

Micropapillary carcinomas are composed of papillary structures without a central vascular core; this distinguishes them form papillary adenocarcinomas. In the lung, a micropapillary component may be associated with any of the subtypes of adenocarcinoma

Immunohistochemistry

Prognosis

Microscopic metastases are common and clinical stage I carcinomas are often up-staged by pathological examination of lymph nodes. Once lymph node metastases occur, the prognosis is poor3.

References

1 Amin, M. B., Tamboli, P., Merchant, S. H., Ordonez, N. G., Ro, J., Ayala, A. G., Ro, J. Y. Micropapillary component in lung adenocarcinoma: a distinctive histologic feature with possible prognostic significance. Am J Surg Pathol 2002;26:358-364.

2 Staebler, A., Heselmeyer-Haddad, K., Bell, K., Riopel, M., Perlman, E., Ried, T., Kurman, R. J. Micropapillary serous carcinoma of the ovary has distinct patterns of chromosomal imbalances by comparative genomic hybridization compared with atypical proliferative serous tumors and serous carcinomas. Human Pathol 2002;33:47-59.

3 Miyoshi, T., Y. Satoh, et al. (2003). "Early-stage lung adenocarcinomas with a micropapillary pattern, a distinct pathologic marker for a significantly poor prognosis." Am J Surg Pathol 27(1): 101-9.

4 Roh, M. S., J. I. Lee, et al. (2004). "Relationship between micropapillary component and micrometastasis in the regional lymph nodes of patients with stage I lung adenocarcinoma." Histopathology 45(6): 580-6.

5 Kuroda N, Hamauzu T, Toi M, et al. Pulmonary adenocarcinoma with micropapillary component: an immunohistochemical study. Case report. Apmis 2005; 113:550-4

This page last revised 27.11.2008.

©SMUHT/PW Bishop